For younger women, the researchers noted that one of the benefits of chemotherapy is typically the suppression of ovarian function. In this study, that effect was instead achieved using hormonal treatments, which may help explain why chemotherapy offered limited additional benefit in many cases.
Expert says OPTIMA trial improves personalized breast cancer care and reduces chemotherapy use
Professor Rob Stein of the UCL Cancer Institute described the results as a significant step forward in personalizing breast cancer treatment. He said the OPTIMA trial helps resolve a key challenge in care—determining which patients truly need chemotherapy—and shows that many can avoid it without affecting outcomes.
He also emphasized that tumor biology can be a more accurate guide for treatment decisions than traditional clinical factors, reducing both the physical and emotional burden of chemotherapy.
Researchers estimate that if the test becomes widely used in the UK’s public health system, over 5,000 patients each year could potentially avoid chemotherapy.
The findings are now under review by NICE, which evaluates new tests and treatments for adoption in the UK’s National Health Service.
